Healthcare Provider Details

I. General information

NPI: 1750994570
Provider Name (Legal Business Name): ISOLYN MAHALIAH HOUSEN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MAITLAND CENTER PKWY STE 310
MAITLAND FL
32751-7442
US

IV. Provider business mailing address

3195 LANCER DR
POWDER SPRINGS GA
30127-3614
US

V. Phone/Fax

Practice location:
  • Phone: 407-426-4800
  • Fax: 407-426-4820
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11005525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: